根据最新报道，数百万美国人放弃了患者保护与平价医疗法案的健康保险数据来自卫生与公众服务部(HHS)。
周五发布的这份报告显示，2026年前两个月，约有1920万人在ACA下注册，比去年同期减少了约300万人。
HHS将报名人数减少归因于其打击欺诈的努力。
该报告称，政府阻止了“150万登记者获得他们没有资格获得的补贴，并在2026年2月之前终止或阻止了另外140万人，总共有290万人此前不当获得了他们没有资格获得的补贴。”
然而，注册人数的减少正值成本上升和增强的保费税收抵免暂停之际。
增强的保费税收抵免，也称为ACA补贴，有助于降低或消除那些通过健康保险市场购买保险的人每月保费的自付费用。
这些补贴是奥巴马政府时期通过的最初ACA的一部分。在新冠肺炎疫情期间，随着资格的提高，财政援助的数额也增加了。这些补贴将于2025年底到期。
10月和11月，补贴成了症结所在在最长的政府关闭期间在美国历史上。
共和党人表示，疫情时代的扩张走得太远了，并试图说服民主党人资助一项临时支出法案，该法案没有解决即将到期的ACA补贴，并承诺稍后讨论继续补贴的方式。
与此同时，民主党人坚持延长保费税收抵免，作为结束关闭的法案的一部分，并警告说，它们的到期可能对数百万美国家庭有害。
一月，房子通过增强的保费税收抵免延长三年，但该措施现在在参议院搁置。
估计美国国会预算办公室(Congressional Budget Office)的数据显示，如果不延期，基准保费总额(标准计划在政府补贴实施前的价格)可能在2026年增长4.3%，在2027年增长7.7%。
一个四月报告精算公司Wakely Consulting Group发现，超过十分之一的ACA注册者没有在年初支付健康保险费。数据还显示了“广泛的购买”，参保者转向较低层次或更便宜的计划。
非营利的KFF找到投保人支付的保费平均增加了58%，从每月113美元增加到178美元，包括那些没有获得增强保费税收抵免的人。
KFF ACA项目的高级政策分析师Emma Wager表示，ACA市场存在欺诈行为，但联邦政府描述的规模可能被夸大了。
“我认为，当你看到联邦政府对这一下降的说法时，他们认为这是打击欺诈和欺诈性招生的结果，”Wager告诉ABC新闻。“根据我们现有的数据，真的不可能确定注册人数的下降有多少与欺诈和人们自愿放弃保险有关。”
她指出，我们知道，从去年到今年，保费“大幅”上涨。
“很多人真的找不到他们家庭负担得起的保险，他们面临着艰难的选择，”她继续说道。“在2025年至2026年期间，人们面临着两位数或三位数的保费增长。”
保险公司之前告诉ABC新闻由于“ACA成员中更高的利用率和更复杂的护理——特别是在急诊室就诊、行为健康和专业药房”,即使没有税收抵免，该计划的费率也在上升。例如，ACA会员使用急诊的比例几乎是雇主赞助保险的两倍。
Wager说，那些选择放弃保险的人，或者那些没有保险的人，如果他们生病、受伤或需要医疗保健，就会面临巨大的经济问题。
“这显然是我们任何人都无法控制的，”她说。“因此，如果你突然住院或生病，花费成千上万美元，而你没有任何形式的保险，你可能会面临破产，你可能会失去你的存款。这是一个非常大的金融风险."
About 3 million fewer people are enrolled under ACA compared to last year: Report
Millions of Americans have dropped health insurance coverage under the Affordable Care Act (ACA), according to newdatafrom the Department of Health and Human Services (HHS).
The report, which was published on Friday, showed that about 19.2 million people were enrolled under the ACA in the first two months of 2026, down by about 3 million people compared to the same time last year.
HHS attributed the lower number of enrollees to its efforts to crack down on fraud.
The report claimed the administration stopped "1.5 million enrollees from receiving subsidies they did not qualify for and ended or blocked another 1.4 million through February 2026, for a total of 2.9 million people who had previously been improperly receiving subsidies they did not qualify for."
However, the decrease in enrollees comes amid rising costs and a pause of the enhanced premium tax credits.
The enhanced premium tax credits, also known as ACA subsidies, help lower or eliminate the out-of-pocket cost of monthly premiums for those who purchase insurance through the health insurance marketplace.
The subsidies were part of the original ACA passed during the Obama administration. The amount of financial assistance was increased along with eligibility during the COVID-19 pandemic. The subsidies expired at the end of 2025.
In October and November, the subsidies became a sticking pointduring the longest government shutdownin U.S. history.
Republicans said the expansions from the pandemic era went too far and tried to persuade Democrats to fund a temporary spending bill that didn't address the expiring ACA subsidies, with promises of discussing ways to continue the subsidies later.
Meanwhile, Democrats insisted on extending the premium tax credits as part of a bill to end the shutdown, warning that their expiration could be detrimental for millions of American families.
In January, the Housepasseda three-year extension of the enhanced premium tax credits, but the measure is now stalled in the Senate.
Estimatesfrom the Congressional Budget Office have suggested that gross benchmark premiums -- the price of a standard plan before government subsidies are applied -- could increase by 4.3% in 2026 and by 7.7% in 2027 without an extension.
An Aprilreportfrom the actuarial firm Wakely Consulting Group found more than one in 10 ACA enrollees did not pay their health insurance premiums at the beginning of the year. Data also showed "extensive buy downs," with enrollees moving to lower-tier or cheaper plans.
The nonprofit KFFfoundthat premium payments from enrollees increased by an average of 58% from $113 to $178 per month, including among those who did not receive the enhanced premium tax credits.
Emma Wager, senior policy analyst for the program on the ACA at KFF, said there is fraud in the ACA marketplace, but the scale described by the federal government may be exaggerated.
"I think when you look at what the federal government has said about this drop, they refer to it as being the result of a crackdown on fraud and fraudulent enrollment," Wager told ABC News. "Given the data that we have, it's really not possible to determine how much of the drop in enrollment is related to fraud versus people voluntarily dropping coverage."
She noted that we know premiums rose "significantly" from last year to this one.
"So many people really couldn't find coverage that was affordable for their families and they were faced with that difficult choice," she continued. "People faced double-digit, triple-digit increases in their premiums between 2025 and 2026."
Insurance companiespreviously told ABC Newsthat plan rates are rising, even without the tax credits, due to "higher utilization and more complex care among ACA members -- particularly in emergency room visits, behavioral health and specialty pharmacy. For instance, ACA members use the ER at nearly twice the rate of those with employer-sponsored coverage."
Wager said those who choose to drop coverage, or those who are uninsured, are at risk of massive financial problems if they become sick, injured or need health care.
"That's obviously something none of us can control," she said. "So if you suddenly have a hospitalization or an illness that costs you thousands and thousands of dollars and you don't have any form of coverage whatsoever, you can face bankruptcy, you can face the loss of your savings. It's a very large financial risk."
